Battling cancer, student graduates from high school

SPOKANE, Wash. ---- Carissa Outen crossed one of many
self-designated finish lines this month when she graduated from
North Central High School.

The 18-year-old has been fighting her second battle with a rare
form of cancer at the same time she finished her senior year. Her
most cherished dreams are to do the things most students do in that
memorable time: go to the prom, walk in her graduation, receive her
diploma.

"Cancer was not supposed to be here for her senior year," said
Britnee Outen, Carissa's older sister. " But she kicked butt. She
made it through."

Not only did Carissa attend the prom and make the
much-anticipated walk despite numerous cancer treatments, she also
led her classmates June 5 in their final act as high school seniors
---- switching over their tassels.

When Steve Gering, North Central's principal, spoke of students
he cannot forget, Carissa's story of "hope and determination" was
the one that made his voice quiver with emotion.

"If I could just capture what you have in a bottle and give it
to others, the world would be a better place," he said.

The entire auditorium at the INB Performing Arts Center was on
their feet in a standing ovation for the teen.

A rare case

Carissa was diagnosed in July 2008 with follicular lymphoma ----
one of 100 known cases worldwide in people younger than 19. The
cells disappeared after six months of chemotherapy, and doctors
told her to expect the cancer to be in remission for at least seven
years.

On Feb. 19, Carissa and her family learned the cancer was back
---- at stage 4, the most severe.

This time, medical professionals hope to knock out the cancer
with a stem-cell transplant. In early June, Carissa and her mother,
Gwen Ashcraft, went to the Seattle Cancer Care Alliance ---- a
collaboration of Fred Hutchinson Cancer Research Center, UW
Medicine and Seattle Children's Hospital ---- to continue
treatment.

But it's hard to tell the teen's life is filled with worry and
uncertainty, even as she spends some of her days and nights in the
Providence Sacred Heart Children's Hospital oncology ward.

Carissa "shrugs it off like it's nothing. To her, this is just
another step we need to take," Britnee said. One day Carissa told
her, "You know, B? Sometimes I just don't feel like I'm sick, and I
don't realize it until my hair starts falling out."

Denise Miller, Carissa's godmother, adds, "When you are in the
presence of uncommon courage, you know it. I've felt that since the
beginning of this journey."

But first, prom

When Carissa found out her cancer had returned, keeping her hair
until the prom was one of those little finish lines. She made it,
but just barely.

When her hair appointment came on prom day, April 24, she was
prepared with a picture of Paris Hilton sporting the hairstyle
she'd planned.

"I didn't want it because it was Paris Hilton," she said. "It
just happened to be on Paris Hilton's head."

That day her head of hair was full, her energy up and her prom
plans on schedule, despite the previous day's round of
chemotherapy.

Generosity from the Spokane community helped make sure the
teen's prom was memorable. Her "pediatric oncology family" at
Sacred Heart paid for a suite at the Davenport Hotel Tower.
Anonymous donors provided limo service and her bejeweled navy blue
prom dress. A local restaurant gave her and her friends a free
dinner.

But her high school classmates had a final surprise at the
dance: They voted Carissa prom queen.

"It was one of those things where you don't care if you get it,
so it's no big deal. But it was really cool," Carissa said. "What
was even cooler was one of my really good friends was voted prom
king."

Less than two weeks later, Carissa's hair started coming out in
clumps.

"It happens fast," she said. "That's what happened last time,
too. I could drag a brush through my hair three times and the
toilet would be full of hair."

And like last time, the teen had her head shaved, bringing an
entourage along to the hair salon for support. They cried, but
Carissa reassured her supporters she was fine.

"I feel comfortable making sure everybody else is OK," she said.
"It's hard for me to care about myself first. I think that's how it
is with everyone in my family. We got it from watching my mom."

Ashcraft has been a single mother for a decade, since Carissa's
father died of colon cancer. He was 40.

"Cancer has us sort of freaked out," Britnee said. "It took our
dad and now it is going after my best friend."

No vacation

During her second round of chemo, Carissa gave a co-worker from
Albertsons a tour around the oncology floor as if it were her own
apartment.

"This is the teen lounge. I had one of my senior pictures taken
there. Here's the boat. These are the fishes," she explained to
Jami Jobes while dragging along a rolling IV bag. "This is a good
view of the city."

The children's cancer unit is painted in a beach theme, inspired
by a chemo patient who was asked what it was like. Not like a day
at the beach, he replied.

Families who spend time there probably feel the same, but
Ashcraft and her other daughters, Britnee and Heather Maynard, try
to avoid tears.

Those closest to Carissa say this round of treatment has been
rougher for her. The chemotherapy regimen involved six hours one
day, four hours the next and 24 hours of a steady drip on the third
day.

"Compared to last time, when I had 19 hours of chemo and I could
literally just unplug and go do whatever I wanted, this was hard,"
she said. "I've been terribly nauseous, extremely exhausted. It was
just not good."

After each round, Carissa stayed home from school about a week
to recover. She worked with a tutor to stay current on her classes,
going to school when she felt up to it.

"I have been going to school semi-regularly for the most part,
but I'm a senior and it's the end of the year and nobody cares, or
at least I'd like to think so," she said.

The intense chemo was meant to create temporary remission so
stem cells could be harvested. A week before graduation, doctors
called Carissa to the hospital to collect the cells, which will be
transplanted after a couple of more radiation and chemotherapy
treatments in Seattle. The procedure is scheduled for late July,
followed by at least 10 days of isolation.

"I can handle being alone. Being alone alone is completely
different," she said.

Many kindnesses

Medically the family knows what's planned, but physically and
emotionally the prospects are frightening.

One day last month when Carissa went to work at Albertsons, a
regular customer gave her an "inspiration bag."

Inside were a brown leather bracelet with "Courage" etched on a
metal plate; a comic of a person slaying a dragon; a napkin with
holy water; and a letter about the woman's own battle with
cancer.

The gesture is just one example of the kindness and generosity
that have touched Carissa and her family in the last few
months.

After learning of the teen's struggle in a Spokesman-Review
story March 14, people from as far away as New York reached out to
help.

Carissa's mother will take a leave from her job at the Spokane
County Jail and temporarily relocate to Seattle to be with her
daughter during treatment. The family has medical insurance, but
lodging, food and other costs aren't covered.

In response, people ordered T-shirts designed by Carissa and
sent donations. Some wanted to target specific uses for the money,
such as her prom. Most chose to remain anonymous.

An elderly couple whose son graduated from North Central and
died of cancer two years later donated $1,000. The same amount came
from another couple in the oncology unit with their own child.

The owner of a manufacturing company offered to help with
transportation to and from Seattle, pay for accommodations while
Carissa and her mother are there, and have a hand in the teen's
college tuition.

A medical assistant class at Spokane Community College held a
fundraiser and donated the money. Two local restaurants donated a
portion of their proceeds. North Central High School led numerous
events, raising nearly $10,000.

"The donations have been wonderful," Ashcraft said. "They've
made sure we have no worries in Seattle."

Steve Fisk, a North Central assistant principal, has helped with
the fundraising.

"I'm impressed with the fact that no one has flinched at all. In
these difficult economic times it's not easy to give, but people
haven't hesitated," Fisk said.

Carissa said the support is wonderful, but asked, "How do you
thank them? People are doing so much. I feel like I need to do
something, but what do you do?"

Looking ahead

The future is what concerns Fisk.

"This is going to be a lifelong journey," he said. "I hope this
is a reminder to all of us. Keep these folks in our thoughts."

Carissa was accepted by Gonzaga University ---- a goal since
early childhood. But with all that's happening, she will wait a
year before starting college. She plans to work and "sort of do
whatever I want," including some travel. She would like to visit
England.

At Gonzaga, she's not sure what she'll study, but it will be
"nursing or business. I'll get through this first, then I'll figure
it out."